DALLAS, June 11, 2015 — Intense education can help stroke survivors quickly recognize symptoms of a subsequent stroke and seek prompt treatment, according to a study in Stroke, Journal of the American Heart Association.

Few stroke patients arrive at an emergency department within three hours of symptom onset. The U.S. FDA has approved the clot-busting drug tissue plasminogen activator, or tPA, to be given within three hours of symptom onset, while the American Heart Association/American Stroke Association suggest it can be given up to 4.5 hours in some patients.

Both intervention groups received standardized packets of material focused on being prepared to recognize and react to stroke symptoms plus a medical alert bracelet so medical professionals would recognize them as SWIFT participants. The interactive intervention group also received in-hospital group sessions featuring role-playing techniques to describe stroke symptoms to EMS workers and video presentations from stroke survivors on preparedness.

The single-center randomized trial included 1,193 mild stroke or TIA survivors, average age 63. Half were women, 51 percent were Hispanic, 26 percent were white and 17 percent were black. During the five-year study, 224 patients experienced a recurrent stroke or stroke-like symptoms. Researchers found that an unprecedented 42 percent of these patients arrived to the emergency room within 3 hours compared to only 28 percent at baseline, a 49 percent increase in the proportion of all patients arriving within three hours of symptom onset. Among Hispanics, there was a 63 percent increase.

This may be the first stroke intervention to reduce racial and ethnic disparities in hospital arrival times.

“Racial-ethnic minorities suffer more strokes and worse stroke outcomes than white Americans and they often show up later to an emergency room to seek critical treatments,” said Bernadette Boden-Albala, M.P.H., Dr.P.H., lead author and professor of public health, Dentistry and Neurology and Associate Dean of Program Development, at Global Institute of Public Health at New York University in New York.

“Our study is the first to show that culturally tailored, health literature educational materials can decrease these racial disparities in stroke preparedness outcomes.”

Both the intensive intervention and the culturally tailored educational messages were likely to decrease time to emergency room arrival, however the intensive intervention appeared to be more beneficial in those with early recurrent events within the first 30 days, researchrers said.

“The continued low rates of people arriving to the emergency department within three hours of stroke symptoms suggests that we may not be effectively disseminating existing materials on stroke preparedness,” Boden-Albala said. “Our findings suggest that at minimum clear, simple, preparedness-focused messages before hospital discharge – and possibly follow-up reinforcement – results in greater proportion of early emergency room arrivals.”

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.

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Related Images

FAST Stroke infographic

F.A.S.T. is:

F - Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile.

A - Arm Weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

S - Speech Difficulty: Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence like, “The sky is blue.” Is the sentence repeated correctly?

T - Time to call 9-1-1: If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately

FAST Stroke infographic

F - Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile.

A - Arm Weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

S - Speech Difficulty: Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence like, “The sky is blue.” Is the sentence repeated correctly?

T - Time to call 9-1-1: If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately